Provider Demographics
NPI:1932150414
Name:TTJ INC.
Entity Type:Organization
Organization Name:TTJ INC.
Other - Org Name:PROGRESSIVE THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:D
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:PTA
Authorized Official - Phone:501-470-3500
Mailing Address - Street 1:582 HIGHWAY 365
Mailing Address - Street 2:STE. 3
Mailing Address - City:MAYFLOWER
Mailing Address - State:AR
Mailing Address - Zip Code:72106-9524
Mailing Address - Country:US
Mailing Address - Phone:501-470-3500
Mailing Address - Fax:501-470-3502
Practice Address - Street 1:582 HIGHWAY 365
Practice Address - Street 2:STE. 3
Practice Address - City:MAYFLOWER
Practice Address - State:AR
Practice Address - Zip Code:72106-9524
Practice Address - Country:US
Practice Address - Phone:501-470-3500
Practice Address - Fax:501-470-3502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR046597Medicare ID - Type Unspecified